Dyslipidemia Drug Table PDF

Drug Name and Class Mechanism of Action Use(s) Adverse Effects Contraindications Nursing Implications HMG- CoA REDUCTASE INHIBITORS “STATINS” prototype:atorvastatin - inhibits enzyme - hypercholesterolemia - myopathy...

Drug Name and Class Mechanism of Action Use(s) Adverse Effects Contraindications Nursing Implications HMG- CoA REDUCTASE INHIBITORS “STATINS” prototype:atorvastatin - inhibits enzyme - hypercholesterolemia - myopathy - pregnancy category X - best class for lowering primarily responsible - reduce risk of CV - muscle - drugs that increase risk LDL cholesterol (also for hepatic synthesis of events pain/weakness of statin side effects lowers TG and cholesterol - mild - severe and toxicity increases HDL) - can lower dose or try - azole antifungals - CYP substrates different statin (fluconazole) - take at evening/bedtime - can be - macrolide antibiotics rhabdomyolysis; this (erythromycin) is severe!! (watch - fibric acid for dark cola colored derivatives urine) (fenofibrate) - hepatic dysfunction - grapefruit juice - increase blood glucose - increase risk for diabetes Drug Name and Class Mechanism of Action Use(s) Adverse Effects Contraindications Nursing Implications BILE ACID SEQUESTRANTS prototype: cholestyramine - binds to bile acids, - decreases LDL - GI - decreases efficacy of causing them to be - little to no effect on - Nausea/Vomiting statins excreted in feces HDL and TG - Diarrhea - decreases efficacy of - result: liver uses excess many orally taken cholesterol to make drugs new bile acids - vitamin supplementation may be required (A, D, E, K) Drug Name and Class Mechanism of Action Use(s) Adverse Effects Contraindications Nursing Implications FIBRIC ACID DERIVATIVES (FIBRATES) prototype: fenofibrate - decrease hepatic - most effective at - severe renal impairment - main indication is for production of TG, lowering serum TG or liver disease TG > 500 mg/dL decrease VLDL - fibrates can - increase risk of cholesterol, increase cause/worsen both bleeding from HDL anticoagulants Drug Name and Class Mechanism of Action Use(s) Adverse Effects Contraindications Nursing Implications CHOLESTEROL ABSORPTION INHIBITOR prototype: ezetimibe - blocks biliary and - dyslipidemia - pregnancy and lactation dietary cholesterol (monotherapy or combo - not recommended in pts absorption with statin) w/ severe hepatic impairment Drug Name and Class Mechanism of Action Use(s) Adverse Effects Contraindications Nursing Implications PCSK9 INHIBITORS prototype: alirocumab - increases activity of - adults with ASCVD - given by subQ injection receptors that clear - familial - so far, seems to be well cholesterol hypercholesterolemia tolerated - very expensive Drug Name and Class Mechanism of Action Use(s) Adverse Effects Contraindications Nursing Implications MISC. DYSLIPIDEMIA AGENT prototype: niacin - no longer - no longer recomm. recommended except in pts with very high TG (>500) - raises blood glucose - increased risk of hepatotoxicity